Methodology 2018

To assess the progress of PHA partner commitments, we work with a team of external verifiers, including:

  • Altarum
  • Center for Active Design
  • Food, Nutrition & Policy Consultants LLC
  • Hudson Institute
  • RTI International
  • Rudd Center for Food Policy and Obesity

Increasing Physical Activity:

To assess Mercedes-Benz, USA’s progress towards meeting its commitment, verifiers reviewed data on distribution of funds to various organizations, key activities for funds, and number of youth reached. Information on coaches was assessed via review of coach training log information including the number of coaches trained and city of placement. Engagement of Mercedes-Benz USA employees was assessed via review of a report providing dates, locations, and number of employees or dealers for engagement events. Data were summed to calculate number of opportunities and participants.

The launch and update of Net Generation by United States Tennis Association (USTA) was assessed via Net Generation website, app, and copies of Net Generation curriculum and promotional materials. Number of youth and parents registered on USTA’s Net Generation website was summed from a website extract of all users. The number of youth served through USTA’s National Junior Tennis & Learning network was provided as a total number by USTA from its records. Number of coaches engaged by USTA was assessed using a report with date of sign up, city, state, and NCSI approval status for each coach that signed up for Net Generation. Data were summed to assess the number of coaches and NCSI-approved coaches that had signed up for Net Generation. Provision of tennis equipment was assessed via detailed information on each type of material or equipment donated and total cost, which were summed across all donations. Safe play provisions were verified using public information available on Net Generation’s website outlining Safe Play program guidelines.

For the Blue Goji commitment, provision and description of funding by the Coleman Fung Foundation to the University of California, Berkeley was verified based on a Fund Terms document signed by both parties that identified the total funding amount and the purpose of the funding. Additional information about the purpose and activities of the Fung Foundation Wellness & Technology Innovations Fellowship were obtained from the University of California, Berkeley website. Verifiers reviewed reports from two student projects to describe community-based pilot programs completed. Number of low-income children was obtained from a public education dataset.

Transforming the Marketplace:

To verify progress on Hyatt’s commitment, calorie, sodium and total sugar averages were calculated for the top two selling a la carte items for breakfast, lunch and dinner from a random sample of 24 hotels of three-meal restaurants and in room dining. Calorie, sodium and total sugar values were averaged across the sample to monitor baseline values and annual changes throughout the commitment. Hyatt also provided three-meal restaurant and in-room dining menus to verify affordability and local procurement commitments.

To measure progress on the Mars Food U.S. commitments for 2017 and 2018, the Mars Food Nutrition Criteria, SKUs and sodium, added sugar and whole grain content were reviewed for existing and new products in the Mars U.S. Food product portfolio. The Uncle Ben’s online recipe database was examined along with nutrition analysis for all Everyday meal recipes available online. Additionally, a summary of Mars Foods media impressions, screenshots of the dotMars internal associate website providing recaps of employee education programs and photos of U.S. site cooking kitchens and fitness facilities were all reviewed. The menu from Mars Corporate Center Café was also reviewed to determine compliance with nutrition and affordability commitments for all U.S. site cafeterias.

Nutri Ventures USA, Inc.’s progress was assessed by reviewing the Nutri-guardians website created by the organization. An independent verifier extensively reviewed website material, documenting availability of various types of content and information and applicability to various key audiences, including professionals and educators.

Progress on the commitment between PHA and Sesame Workshop and the Produce Marketing Association was assessed via review of data on sub-licensee applicants, which included names of organizations seeking use of Sesame Workshop Assets, as well as character requests and associated fruits and vegetables. These findings were totaled and reported.

Progress on commitments made by Vintner Distributers, Tri Star Energy, Ricker’s, Cumberland Farms, Aloha Petroleum, Enmarket, and Maverik Inc. was determined by reviewing inventory reports, sales data and photos from stores to confirm that a minimum number of types of fruits, vegetables, whole grain products and low-fat dairy options were available. When applicable, verifiers reviewed store planograms and spreadsheets of products’ nutritional information to ensure stores offered a minimum number of products and grab and go items that met PHA’s definition of a Healthier Food and Beverage Product Criteria and to calculate linear feet of shelf space dedicated to fruits, vegetables, whole grains and low fat dairy. For healthier combo meals, verifiers reviewed recipes, nutritional information and store menus to ensure options are available that meet PHA’s Healthier Recipe Criteria. Verifiers reviewed employee handbooks and policies to confirm commitment elements around healthy employee benefits and access to bicycle racks.

To measure progress on food and beverage distributors, Core-Mark International provided its marketing program book, a list of all products that meet PHA’s healthier food and beverage product criteria, access to its online ordering website and online mobile ordering application and examples of “Promo Power” and “Good Health to Go” promotional materials for verification. Verifiers also reviewed Core-Mark International’s employee wellness promotion materials, an employee health discount program overview, and the company’s healthier food catering guide. Progress on S. Abraham and Sons’ commitment was assessed based upon a review of its “On the Shelf” weekly marketing newsletter, a list of all products that meet PHA’s healthier food and beverage criteria, a new two-page tear pad featuring only products that meet PHA’s criteria and materials supporting the “Whole Lot Better” program including its auto-ship program, header, shelf strip and planogram. Progress on commitments related to a healthier workforce at S. Abraham and Sons included a review of products in vending machines in the corporate office and warehouses, Drink Up materials on or near free water sources, communications to employees about wellness programming and healthy practices. Progress on Esstar’s commitments was assessed based upon review of planograms, photos, nutrition information for all products that meet PHA’s product criteria and examples of in store and at the pump advertisements and signage.

The National Association of Convenience Stores provided screen shots of its website outlining details of its PHA partnership and copies of emails to member companies encouraging engagement with PHA. Presentations from its Corner Store Forum were made available to assess outreach to members with new marketing resources and business tools, best practices in the SNAP and WIC programs and case studies from successful healthy food retailers.

PepsiCo’s progress towards meeting commitments to reduce added sugars in its beverage portfolio and reduce saturated fat and sodium in its foods portfolio were reviewed by an independent verifier during a meeting held at PepsiCo headquarters in Purchase, New York in November 2018. The verifier reviewed SKU-level data on beverages and foods sold in PepsiCo’s top 26 global beverage markets and top 23 global foods markets in 2017, as well as governance documents detailing the methodology used by PepsiCo to determine the total beverage and food volumes sold and nutritional information related to products sold, including definitions, assumptions, calculations, and rounding procedures. Product data and methods were reviewed for completeness against commitment guidelines agreed upon by PepsiCo and Partnership for a Healthier America, as well as publicly available information on PepsiCo products. Calculations were reviewed for accuracy and reproducibility using a random sample of beverage and food products from PepsiCo’s portfolio and publicly available data on nutrients in the selected products.

The Hudson Institute Obesity Solutions Initiative (OSI) is serving as third-party validator of the National Confectioners Association’s Always a Treat commitment. In addition, Richard Black, PhD, Tufts University has provided input to the analytical methodology and examined the final conclusions and analyses.

IRI data for the 52 weeks ending December 25, 2016 were utilized to identify and analyze participating companies’ Instant Consumable candy and chocolate item sales (excluding gift items, gum and mints) according to two discreet categories: items that are ≤ 200 calories per pack, and those that are > 200 calories per pack. For purposes of this study, Instant Consumables are defined as all candy and chocolate items (excluding gift packs, gum and mints) sold in packages ≤ 3.2 ounces (90 grams).

A tracking of whether calorie counts appear on the front of participating companies’ candy and chocolate items, except gift items, very small packages (< 12 sq. inches of total available label space), gum and mints, was performed. Companies supplied physical examples of packages by SKU in order for Hudson Institute to verify whether calorie information has been placed on the front of pack (FOP). To cross-check the packaging information supplied by each company, the Hudson team commissioned visual audits of confection products at retail checkout lanes in 9 cities across the country. Audits were conducted by teams of Independent Registered Dietitians between December 8, 2017 and December 15, 2017.

Giant’s commitment to achieving stars on its private label brand products was verified by reviewing a list of all private label brand products and their associated star status. Products receiving 1, 2, or 3 stars through the Guiding Stars system were summed to determine total number of starred products. For front-of-pack labeling, a verified randomly selected 50 products from Giant’s private label brand list and requested front-of-pack label proofs for these items. Of these, 24 products were excluded because they did not carry front-of-pack labels (e.g., bulk foods) or the labels were unavailable. For the 26 products with labels, a verifier reviewed front-of-pack label proofs to determine how many products had labels that included calories, saturated fat, sodium, and total sugars. FNV campaign activation and local athletes used in campaigns were verified through dated press releases identified from public news sources. A list of specific stores activating FNV and their addresses was obtained from PHA.

Creating Healthier Places:

Sodexo and independent verifiers worked together to add verification questions to existing data collection instruments already in place at Sodexo. Sodexo provided verifiers with site names, locations, and responses to the survey, which verifiers used to calculate the percentage of sites selling or serving Mindful products. Achievement of Mindful Healthy Dining program gold status in corporate, government, hospital, and university settings was assessed via survey. Survey instruments were developed by Sodexo and an independent verifier and specific to each account type. A total of 343 of 624 corporate accounts (55% response rate), 11 of 20 government accounts (55% response rate), and 272 of 327 university accounts (response rate 83%) participated in the survey. Sodexo provided raw survey response data, which were analyzed by an independent reviewer to calculate the number of accounts achieving gold status. Implementation of PHA Hospital Healthy Food Initiative guidelines was assessed via survey and document review. The survey was developed by Sodexo and an independent verifier and used to collect data from hospital account managers on nutrition labeling, food marketing, check out stations, and fried food practices. A total of 596 hospital accounts were eligible to complete the survey and 593 completed the survey (99% response rate). Raw survey data were supplied to the independent verifier for analysis and determination of guidelines met. The percentage of food purchases that were fruits or vegetables for each hospital was calculated by independent reviewers based on procurement data submitted by hospitals that detailed foods and food purchase amounts for one calendar year, July 2017-June 2018. The percentage of hospital beverage purchases that consisted of healthier beverages, according to specific nutrition criteria, was calculated by independent reviewers based on procurement data submitted by hospitals that details all beverage types, nutrition facts, and purchase amounts for one calendar year, July 2017-June 2018. After the percentage of healthier beverages was calculated, hospitals were given credit for offering free water to customers by multiplying healthier beverage purchases by 5%, 10%, or 15% if the hospital provided photographic documentation that they had a drinking water fountain or station with free cups; chilled water, free cups, and ice; or a water station with free fruit slices or promotional messaging encouraging water consumption, respectively. If a hospital had met either the fruit and vegetable procurement criteria or the beverage procurement criteria in a prior year, they were counted along with hospitals achieving the criteria this year. Trinity Health’s progress towards meeting its commitment was assessed via review of a grant report that included grant award recipients, amount of award, amount of cash match, date of award, length of award, and key activities to be completed. Number of grants, total value of grants, and total cash match were summed across all awards.

Active Design Verified

To verify the progress of our partners in meeting the active design criteria, verifiers reviewed the technical building plans, photographs, and related documentation for each affordable housing site. Verifiers ensured that each building was designed using the evidence-based strategies outlined in the developer’s commitment.

Food Banks

To verify future progress on Des Moines Area Religious Council, Capital Area Food Bank, San Antonio Food Banks and Atlanta Community Food Bank, verifiers reviewed baseline information on produce distributions, school food pantries, family markets, summer food sites and meals served, afterschool meals and weekend meals served. San Antonio Food Banks provided monthly reports on nutrition education classes, gardening activities and a list of healthier recipes for review. Verifiers also examined Capital Area Food Bank’s wellness metrics, Partners for Wellness criteria and partner list, and wellness food distributions.

Healthier Campus Initiative

Each post-secondary education institution participating in the Healthy Campus Initiative selected twenty-three elements across the following categories: food and nutrition, physical activity and movement, and wellness programming.

For food and nutrition guidelines, independent verifiers reviewed two days, that were selected by the independent verifier, of breakfast, lunch, and dinner menus for each campus dining venue. Menus, which included nutrient information, allowed verifiers to ensure nutrient targets were met for calories, percent calories from saturated fat, grams of trans fat, and milligrams of sodium in wellness meals. Verifiers utilized production records, planograms, recipes, nutrition facts panels, product specifications, and additional photographs to determine whether campuses offered fruits, vegetables, whole grains, and plant-based food options and limited fried foods and desserts. Procurement records, sales records, and nutrition information were also reviewed and evaluated to verify healthy vending and beverage purchases. Campuses provided additional photographic evidence to verify their use of healthy icons and calorie labeling at the point of purchase. Policies were reviewed to determine the use of local procurement programs, tray-less dining initiatives, and merchandising programs to promote nutritious options. To verify availability of water in each dining, recreation, and educational facility, campuses provided an inventory of water fountains, bottle filling stations, and access points for filtered water in at least five percent of the campus buildings, selected by the verifier.

Physical activity elements were verified through campus maps, photographs, and policies outlining walking and biking infrastructure, access to public transportation, and recreation, physical activity, and competitive sports opportunities.

Wellness elements were verified by examining policy and program documentation to determine whether integrated, comprehensive wellness programming including breastfeeding support, strategies to reduce food insecurity, health insurance benefits, and access to hands-on nutrition education and cooking classes were provided.

Early Childhood and Out-of-School Time

Progress on commitments for the Boys and Girls Clubs of America (BGCA) was measured via the Healthy Eating and Physical Activity (HEPA) inventory and document review. BGCA clubs with early childhood or afterschool programs that had committed to implementing the HEPA standards in their programs participated in the inventory. Respondents reported whether they were “Fully Demonstrating,” “Not Fully Demonstrating” or it was “Not Feasible” to demonstrate each HEPA standard individually at their program site. A random sample of 28 clubs that completed the inventory were asked to submit program documents, including daily schedules, menus, program handbooks, and parent outreach materials, which were then reviewed by verifiers against definitions of meeting each of the HEPA standards. Verifiers analyzed the inventory to determine the percentage of clubs meeting each of the standards and the document review data to provide a confidence level on whether clubs had the documentation showing that they were meeting the standards. The confidence level is based on the document audit of 28 clubs and reflects the proportion of audited clubs that submitted clear or plausible evidence to support a claim that they were fully implementing a commitment element. We established four categories: Highly confident=76 to 100% of clubs that said they were demonstrating a commitment element submitted clear or plausible evidence to support their claim; Confident= 51 to 75%; somewhat confident= 26 to 50%; not confident= 0 to 25%. To assist clubs in implementation, BGCA with the Alliance developed training courses and technical assistance resources to facilitate standards implementation.

Progress on commitments made by Bright Horizons Family Solutions was measured with survey and document review. A survey was administered by Bright Horizons Family Solutions in September 2017 to center directors to determine baseline measures related to current movement and gardening activities. A total of 266 out of 700 Bright Horizons centers responded to questions (response rate of 38%). Documentation of trainings offered to center directors and feedback from trainings was used to determine what training opportunities were provided. A copy of Bright Horizons Family Solutions’ Spark magazine and information on the recipe challenge from its website were reviewed to determine what healthy eating and physical activity information was provided to teachers. Verifiers also reviewed resource documents of healthy eating and physical activity information that was provided to parents.

KinderCare Education’s commitment to removing grain-based desserts was verified using a five-week cycle menu from 2016 prior to implementation and a four-week cycle menu from 2018 after implementation. Development of a curriculum was verified by a review of training modules that were part of the curriculum. The assessment of garden offerings was verified using 2018 survey data collected by KinderCare Education from 1,307 representatives from its centers.

Next: Transforming the Marketplace

Related Reading